Unipolar mani ve bipolar bozukluk hastalarının BDNF ve sitokin düzeylerinin karşılaştırılması
Yükleniyor...
Dosyalar
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Yapılan çalışmalarda bipolar bozukluğun farklı alt tiplere ayrıldığı gösterilmiştir. Unipolar maninin bipolar bozukluğun bir alt tipi olduğunu ve ayrı tanı olarak ele alınması gerektiğini savunan birçok araştırmacı mevcuttur. Literatürde unipolar mani ve bipolar bozukluk tanılı hastaların farklılıklarını ortaya koyan araştırmalar yapılmıştır. Fakat iki grubu karşılaştıran çalışmalarda sitokinler ve beyin kaynaklı nörotrofik faktörler incelenmemiştir. Bu çalışmada, unipolar mani ve bipolar bozukluk tanılı hastalarında sosyodemografik, klinik özellikler, serum beyin kaynaklı nörotrofik faktör ve sitokin düzeylerinin karşılaştırılması amaçlanmıştır. Bu araştırmaya, Trakya Üniversitesi Tıp Fakültesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı polikliniğine başvuran, DSM-5 tanı ölçütlerine göre 42 bipolar bozukluk tanılı hasta ve 38 unipolar mani için tanı ölçütlerini karşılayan ötimik dönemdeki hastalar dahil edildi. Katılımcılara sosyodemografik veri formu, Young Mani Derecelendirme Ölçeği, Hamilton Depresyon Derecelendirme Ölçeği, Temperament Evaluation of Memphis, Pisa, Paris ve San Diego- Autoquestionnaire, Çocukluk Çağı Ruhsal Travma Ölçeği, Standartize Mini Mental Test uygulandı. Tüm katılımcılardan kan alınarak serum beyin kaynaklı nörotrofik faktör, interlökin-1beta, interlökin-6, tümor nekrotizan faktör-alfa, C-reactive protein, lökosit düzeylerine bakıldı. Araştırmamızda 495 bipolar bozukluk tanılı hastadan %7,7’sinin unipolar mani tanı ölçütlerini karşıladığı tespit edildi. Bipolar bozukluk grubunda unipolar mani grubuna göre geçmiş özkıyım düşüncesinin, remisyonda kalma süresinin uzun olduğu istatistiksel olarak daha yüksek olduğu bulundu. Manik atak sayısının, hastanede yatış sayısının unipolar mani grubunda bipolar bozukluk grubundan istatistiksel olarak daha yüksek saptandı. Tüm manik belirtiler 66 arasından öfori, cinsel ilgi artışı, grandiyozite ve hezeyan gibi semptomların görülme oranı unipolar mani grubunda istatistiksel olarak daha yüksek olduğu tespit edildi. Hipertimik, siklotimik ve depresif mizaç özelliklerinin unipolar mani grubunda anlamlı olarak daha yüksekti. Bipolar bozukluk grubundaki hastaların halen en çok kullanmakta oldukları duygudurum düzenleyicisinin lityum olduğu, unipolar mani grubunda ise en çok kullanılan duygudurum düzenleyicisinin valproik asit olduğu tespit edildi. İnterlökin-6 ve C-reactive protein düzeylerinin unipolar mani grubunda bipolar bozukluk grubuna göre anlamlı düzeyde daha yüksek olduğu bulundu. Bipolar bozukluk grubunda interlökin-1beta düzeyleri ve hastalık süresi arasında negatif ilişki saptandı. Ayrıca tüm katılımcıların birleştirilerek oluşturulan örneklemde IL-6 düzeylerinin özkıyım girişim öyküsü olmayan hastalarda istatistiksel olarak daha yüksek tespit edildi. Bu araştırma unipolar mani ve bipolar bozukluk hastalarının karşılaştırılmasında beyin kaynaklı nörotrofik faktör ve sitokinleri inceleyen ilk çalışmadır. Çalışmamızın bulgularından; iki grubun sosyodemografik ve klinik özelliklerindeki farklılıklar ile birlikte, interlökin-6 ve Creactive protein düzeylerinin unipolar mani grubunda daha yüksek saptanması, unipolar maninin ayrı bir tanı olma olasılığını desteklemektedir.
Studies have shown that bipolar disorder is divided into different subtypes. There are many researchers who claim that unipolar mania is a subtype of bipolar disorder and should be treated as a separate entity. In the literature, studies revealing the differences of patients with unipolar mania and bipolar disorder have been conducted, but studies comparing the two groups have not explored cytokines and brain-derived neurotrophic factors. In this study, it was aimed to compare sociodemographic, clinical features, serum brain-derived neurotrophic factor and cytokine levels in patients with unipolar mania and bipolar disorder. This study included 42 bipolar disorder and 38 unipolar mania patients in the euthymic period who applied to the psychiatry outpatient clinic at the Trakya University Medical School Hospital who met the diagnostic criteria according to DSM-5, respectively. Sociodemographic data questionnaire, Young Mania Rating Scale, Hamilton Depression Rating Scale, Temperament Evaluation of Memphis, Pisa, Paris and San Diego- Autoquestionnaire, Childhood Trauma Questionnaire, Standardized Mini Mental Test were applied to the participants. Blood was obtained from all participants and serum brain-derived neurotrophic factor, interleukin-1beta, interleukin-6, tumor necrotizing factor-alpha, C-reactive protein, leukocyte levels were examined. In our study, 7,7% of 495 patients diagnosed with bipolar disorder met unipolar mania diagnostic criteria. In the bipolar disorder group, female gender, suicidal thought history, and longer remission time were found to be statistically higher than the unipolar mania group. The number of manic episodes and the number of hospitalizations were statistically higher in the unipolar mania group than in the bipolar disorder group. Among all the manic symptoms, incidence of symptoms such as euphoria, increased sexual interest, grandiosity and delusions were found to be statistically higher in the unipolar mania group. Hyperthymic, cyclothymic and depressive temperament features were significantly higher in the unipolar mania group. It was found that lithium was and still is the most frequently used mood stabilizer in the bipolar disorder group, while the valproic acid was and still is the most frequently used mood stabilizer in the UM group. Interleukin-6 and C-reactive protein levels were significantly higher in the unipolar mania group than in the bipolar disorder group. There was a negative relationship between interleukin-1beta levels and illness duration in bipolar disorder group. In addition, IL-6 levels were statistically higher in patients without suicide attempt history in the sample that included all participants. This study is the first study to investigate brain-derived neurotrophic factors and cytokines in the comparison of patients with unipolar mania and bipolar disorder. From the findings of our study; Along with differences in the sociodemographic and clinical features of the two groups, higher levels of interleukin-6 and C-reactive protein levels in the unipolar mania group support the possibility of unipolar mania being a separate entity.
Studies have shown that bipolar disorder is divided into different subtypes. There are many researchers who claim that unipolar mania is a subtype of bipolar disorder and should be treated as a separate entity. In the literature, studies revealing the differences of patients with unipolar mania and bipolar disorder have been conducted, but studies comparing the two groups have not explored cytokines and brain-derived neurotrophic factors. In this study, it was aimed to compare sociodemographic, clinical features, serum brain-derived neurotrophic factor and cytokine levels in patients with unipolar mania and bipolar disorder. This study included 42 bipolar disorder and 38 unipolar mania patients in the euthymic period who applied to the psychiatry outpatient clinic at the Trakya University Medical School Hospital who met the diagnostic criteria according to DSM-5, respectively. Sociodemographic data questionnaire, Young Mania Rating Scale, Hamilton Depression Rating Scale, Temperament Evaluation of Memphis, Pisa, Paris and San Diego- Autoquestionnaire, Childhood Trauma Questionnaire, Standardized Mini Mental Test were applied to the participants. Blood was obtained from all participants and serum brain-derived neurotrophic factor, interleukin-1beta, interleukin-6, tumor necrotizing factor-alpha, C-reactive protein, leukocyte levels were examined. In our study, 7,7% of 495 patients diagnosed with bipolar disorder met unipolar mania diagnostic criteria. In the bipolar disorder group, female gender, suicidal thought history, and longer remission time were found to be statistically higher than the unipolar mania group. The number of manic episodes and the number of hospitalizations were statistically higher in the unipolar mania group than in the bipolar disorder group. Among all the manic symptoms, incidence of symptoms such as euphoria, increased sexual interest, grandiosity and delusions were found to be statistically higher in the unipolar mania group. Hyperthymic, cyclothymic and depressive temperament features were significantly higher in the unipolar mania group. It was found that lithium was and still is the most frequently used mood stabilizer in the bipolar disorder group, while the valproic acid was and still is the most frequently used mood stabilizer in the UM group. Interleukin-6 and C-reactive protein levels were significantly higher in the unipolar mania group than in the bipolar disorder group. There was a negative relationship between interleukin-1beta levels and illness duration in bipolar disorder group. In addition, IL-6 levels were statistically higher in patients without suicide attempt history in the sample that included all participants. This study is the first study to investigate brain-derived neurotrophic factors and cytokines in the comparison of patients with unipolar mania and bipolar disorder. From the findings of our study; Along with differences in the sociodemographic and clinical features of the two groups, higher levels of interleukin-6 and C-reactive protein levels in the unipolar mania group support the possibility of unipolar mania being a separate entity.
Açıklama
Anahtar Kelimeler
Bipolar Bozukluk, Unipolar Mani, Beyin Kaynaklı Nörotrofik Faktör, Sitokinler, C-reactive Protein, Bipolar Disorder, Unipolar Mania, Brain-Derived Neurotrophic Factor, Cytokines, C-reactive Protein
